One Scientist's Quest To Vanquish Epileptic Seizures

The dream of epilepsy research, says neurobiologist Ivan Soltesz, is to stop seizures by manipulating only some brain cells, not all.

Steve ZyliusUC Irvine Communications

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Originally published on April 18, 2014 7:13 pm

In the early 1990s, a young brain researcher named Ivan Soltesz heard a story that would shape his career.

His adviser told him about a school for children whose epileptic seizures were so severe and frequent that they had to wear helmets to prevent head injuries. The only exception to the helmet rule was for students who received an award.

"The big deal for them is that they can take the helmet off while they're walking across the stage," Soltesz says. "And that thing struck me as just wrong."

Today, Soltesz runs a lab at the University of California, Irvine, and he's taken some big steps toward helping people with uncontrolled seizures. Epilepsy drugs aren't enough, he says. For about a third of patients with epilepsy, they just don't work. And for many others, they have major drawbacks.

"The big problem with current medications is precisely that the medication is everywhere in the brain," Soltesz says. "It's affecting virtually all the cells all the time." That is one reason epilepsy drugs often cause side effects like fatigue, dizziness and blurred vision.

So Soltesz, with major funding from the National Institute of Neurological Disorders and Stroke, has been looking for a way to stop seizures without drugs. "The dream of epilepsy research is really to intervene only when the seizures are occurring and only manipulating some cells but not all of the cells," he says. And Soltesz has done that — in mice.

Seizures occur when brain cells start firing abnormally and rapidly, like a car speeding out of control. Soltesz found a way to spot the first signs of trouble. Then, using a technique called optogenetics, he delivered a pulse of light that activated the brain's own system for slowing down runaway cells.

"We either decreased the activity of the gas pedal or increased the activity of the brake," he says. "And through both ways we succeeded in making the seizures stop when the light came on."

The approach only works in animals with brain cells that have been genetically altered. But a similar approach could be used to stop epileptic seizures in people, Soltesz says.

And that day may not be far off. President Obama's BRAIN initiative, announced a year ago, has made finding better treatment for epilepsy one of its priorities. Also, late last year the Food and Drug Administration approved the first implanted device that delivers electrical stimulation to the brain when cells begin firing abnormally.

This device can reduce seizures. And Soltesz hopes that future implanted devices will be able to stop seizures entirely in people with severe epilepsy, including children who must wear "seizure helmets."

"Imagine if those kids could just take the helmet off because they know that the seizures would be stopped with this new intervention," Soltesz says. "That would be just simply fantastic."

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Transcript

AUDIE CORNISH, HOST:

It's been a year since President Obama announced his brain initiative. That's a plan to explore the human mind, and find new ways to treat brain disorders. Since then, one disorder in particular has received a lot of attention: epilepsy. NPR's Jon Hamilton reports on a scientist who hopes the brain initiative will help him revolutionize the treatment of epileptic seizures.

JON HAMILTON, BYLINE: In the early 1990s, a young brain researcher named Ivan Soltesz heard a story that would shape his career. His adviser told him about a school for children with severe epilepsy. The students had so many seizures that in order to avoid head injuries, they had to wear helmets all day, every day. Soltesz says there was one exception to the helmet rule.

IVAN SOLTESZ: These children, when they get an award in the school, they can - of course - go to the stage and receive the award, and the big deal for them is that they can take the helmet off while they are walking across the stage. And, you know, I was a young guy, and that thing struck me as just wrong. And so that was really, what originally motivated me.

HAMILTON: Today, Soltesz runs a lab at the University of California- Irvine, and he's taken some big steps toward helping people with uncontrollable seizures. Soltesz ays epilepsy drugs aren't good enough. For about a third of patients, they just don't work; and for many others, they have major drawbacks.

SOLTESZ: The big problem with current medications is precisely that medication is everywhere in the brain. It's affecting virtually all the cells, all the time. That is why the medications almost invariably have side effects.

HAMILTON: Like fatigue and dizziness and blurred vision. So Soltesz, with major funding from the National Institute of Neurological Disorders and Stroke, has been looking for a way to stop seizures without drugs.

SOLTESZ: The dream of epilepsy research is really, to intervene only when the seizures are occurring and only manipulating some cells, but not all of the cells.

HAMILTON: And Soltesz has done that in mice. Seizures happen when brain cells start firing rapidly, like a car speeding out of control. So Soltesz found a way to spot the first signs of trouble, then deliver a pulse of light that causes certain brain cells to slow down.

SOLTESZ: So we either, if you want, decrease the activity of the gas pedal, or increase the activity of the brake. And through both ways, we succeeded in making the seizures stop when the light came on.

HAMILTON: The approach only works in animals whose brain cells have been genetically altered, but Soltesz says it shows how epileptic seizures could be stopped in people. And he believes the president's brain initiative will help him translate his success in mice to humans, including children with epilepsy so severe they have to wear helmets.

SOLTESZ: Imagine if those kids could just take the helmet off because they know that the seizures would be stopped with this new intervention. That would be just simply fantastic.

HAMILTON: And it may not be so far off. Several months ago, the Food and Drug Administration approved the first implanted device that can deliver electrical stimulation to the brain when cells begin firing abnormally. It reduces seizures. Soltesz hopes future devices will stop them entirely. Jon Hamilton, NPR News.

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